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69990

Restricted coverageAdd-on code

Microsurgery add-on

69990 is an add-on code — it is only payable alongside a primary procedure: 61304, 61305, 61312, 61313, 61314, 61315, 61316, 61320, 61321, 61322, 61323, 61330, 61333, 61340, 61343, 61345, 61450, 61458, 61460, 61500, 61501, 61510, 61512, 61514, 61516, 61517, 61518, 61519, 61520, 61521, 61522, 61524, 61526, 61530, 61531, 61533, 61534, 61535, 61536, 61537, 61538, 61539, 61540, 61541, 61543, 61544, 61545, 61546, 61550, 61552, 61556, 61557, 61558, 61559, 61563, 61564, 61566, 61567, 61570, 61571, 61575, 61576, 61580, 61581, 61582, 61583, 61584, 61585, 61586, 61590, 61591, 61592, 61595, 61596, 61597, 61598, 61600, 61601, 61605, 61606, 61607, 61608, 61611, 61613, 61615, 61616, 61618, 61619, 61623, 61624, 61626, 61630, 61635, 61640, 61641, 61642, 61645, 61650, 61651, 61680, 61682, 61684, 61686, 61690, 61692, 61697, 61698, 61700, 61702, 61703, 61705, 61708, 61710, 61711, 62010, 62100, 63081, 63082, 63085, 63086, 63087, 63088, 63090, 63091, 63101, 63102, 63103, 63170, 63172, 63173, 63185, 63190, 63191, 63197, 63200, 63250, 63251, 63252, 63265, 63266, 63267, 63268, 63270, 63271, 63272, 63273, 63275, 63276, 63277, 63278, 63280, 63281, 63282, 63283, 63285, 63286, 63287, 63290, 63295, 63300, 63301, 63302, 63303, 63304, 63305, 63306, 63307, 63308, 63704, 63706, 63707, 63709, 63710, 64831, 64834, 64835, 64836, 64840, 64856, 64857, 64858, 64861, 64862, 64864, 64865, 64866, 64868, 64885, 64886, 64890, 64891, 64905, 64907.

Restricted coverage: Covered only in unusual circumstances; special instructions apply.

2026 Medicare payment

Estimated allowed amounts. Pick a locality or enter a ZIP; toggle modifiers to see how the payment rules change the number.

Show values as
Modifiers
LineQtyNon-facility (office)Facility (hospital/ASC)
699901$198.07$198.07
Conversion factor: Locality: national average GPCIs

RVU breakdown (national)

Relative value units before geographic adjustment. Payment = (work×GPCIw + PE×GPCIpe + MP×GPCImp) × CF

RowWork RVUPE RVU (office)PE RVU (facility)MP RVUTotal (office)
699903.371.171.171.395.93

Payment policy for 69990

CMS's indicator fields, translated. These control which modifiers are payable and how.

Professional/technical (PC/TC)

pctc=0

Physician service

Cannot be split into professional/technical components — modifiers 26 and TC don't apply.

Multiple procedures

mult_surg=0

No reduction

No multiple-procedure payment adjustment applies (typical for add-on codes).

Bilateral (modifier 50)

bilt_surg=0

150% rule doesn't apply

Bilateral adjustment does not apply (e.g., the code is unilateral by definition or physiology).

Assistant surgeon (80/81/82)

asst_surg=2

Payable

Assistant at surgery (mod 80/81/82) is paid at 16% of the fee schedule amount.

Co-surgeons (modifier 62)

co_surg=0

Not permitted

Co-surgeons (mod 62) may not be paid for this procedure.

Team surgery (modifier 66)

team_surg=0

Not permitted

Team surgery (mod 66) may not be paid for this procedure.

Source: pfs.data.cms.gov "Indicators for 2026", retrieved 2026-07-16; conversion factors $33.4009 / $33.5675 (QP) per CMS-1832-F. Estimated amounts — not billing or coding advice.

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